Type 2 diabetes patients at risk for overactive bladder
MedWire News: Overactive bladder (OAB) is common in patients with Type 2 diabetes, affecting almost a quarter of patients, half of whom suffer from active urinary incontinence, report researchers.
Men and older diabetes patients are more likely to have OAB, and older age and larger waist circumference increased the likelihood of having OAB wet (incontinence), their findings suggest.
"Taken together, we suggest that urologists and diabetologists should pay attention to the existence of OAB in diabetic populations," remark Yao-Chi Chuang (Kaohsiung Medical Center, Taiwan) and colleagues.
"These findings can help guide the collaboration between [these specialists] to work towards developing screening methods and early treatment of urologic complications in higher risk patients," they suggest in the journal Urology.
Previous research links diabetes to OAB through increased presence of systemic inflammation, neuropathy, cardiovascular complications, and metabolic syndrome, note the researchers, who examined the relationship between OAB and markers of diabetes mellitus in 1359 individuals (707 men) with Type 2 diabetes.
Participants completed a self-administered questionnaire including the OAB symptom score. This assesses daytime frequency (score 0-2), nighttime frequency (score 0-3), urgency (score 0-5), and urinary incontinence (score 0-5).
Chuang and colleagues defined OAB as an urgency score of at least 2, and a sum score of at least 3. A score of 2 or more (once a week or more) for urgency incontinence in patients with OAB denoted OAB wet, and the sum score gave a severity rating: none (0-2), mild (3-5), moderate (6-11), or severe (≥12).
Patient interviews evaluated personal disease history, smoking, drinking, age, duration of diabetes mellitus, microvascular complications of diabetes, as well as other relevant parameters.
In all, 22.5% of participants reported OAB, including 11.7% OAB dry and 10.8% OAB wet. More men had OAB than women, at 24.8% versus 20.1%. The differences in OAB symptom score between those with no OAB, OAB dry, and OAB wet were significant, at 2.5, 5.9, and 8.9, respectively.
Among those with OAB, 25.5% cases were mild, 65.0% were moderate, and 9.5% were severe, respectively.
OAB prevalence increased with increasing age and diabetes duration, report the researchers. Specifically, OAB and OAB wet was 2.4 and 4.2 times more prevalent in patients with a diabetes mellitus duration of more than 10 years and age more than 50 years than younger patients with a shorter disease duration.
Multivariate analysis showed that male gender increased the risk for OAB by 1.37-fold. This could be a result of the men in the study being older than 60 years on average and having a high prevalence of benign prostatic hyperplasia, which can contribute to OAB, say Chuang et al.
Further analysis revealed that OAB wet participants had larger waist circumference measurements and were older than nonOAB patients, at 90.9 versus 88.7 cm, and 67.4 versus 61.6 years, respectively. Both factors were significant predictors of OAB wet on multivariate analysis.
Of note, no differences in OAB wet and nonOAB patients were found regarding diabetic profiles, including HbA1c level, lipid profile, uric acid levels, blood cell count, renal function, and blood pressure, conclude the researchers.
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By Sarah Guy